Depression: a virus of the heart

Craig McGregor

Black mood: The onset of anxiety and depression can be sudden and inexplicable.

I still don’t know what caused it. I woke up one morning feeling anxious, which I rarely do.

I shrugged it off and went to work in the normal way. But next morning I woke up very early, feeling even more anxious: not about anything in particular, and try as I might, I couldn’t work out what I was anxious about. During the week, my anxiety deepened, usually in the morning, and as it got progressively worse, I found myself incapable of working and, worse still, incapable of sleeping or even of thinking coherently.

By the end of the second week, I realised that I couldn’t go on like that any longer. I was suffering depression. Clinical depression. Black, unforgiving, unprecedented depression. I was fearful. All my emotions were out of control. I couldn’t sleep. When I finally slept, I was afraid of waking up, because I knew the day would be even worse.

I explained what was happening to me to the University of Technology, Sydney, where I was Associate Professor, and they said I should take some time off. I resisted at first, because I was head of a department, but my condition got worse.

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One night, I cancelled my journalism lecture, then decided to give it anyhow, and noticed the students were staring at a deep ugly bruise on the side of my face. I realised that during the day I had thrust my fist so hard into my face, in despair, that I had damaged it.

At the very depth of my depression, I spent days lying and writhing around my bed, unable to do anything, hardly able to speak. I felt myself spiralling downward, downward into the most terrible and despairing experience of my life. Because I could hardly bear to go on living any longer, I tried to work out ways to commit suicide – me, who had been so joyful and celebratory all my life. To kill myself would have been the ultimate defeat, the utter end of everything for which I had stood.

My loving wife, Jane, and drugs, and Dr Kay Wilhelm, Conjoint Professor of Psychiatry at NSW University, rescued me. Jane because she comforted me, reassured me, told me continually that I would get over it, forced me to get out of bed when it was the last thing I could bear to do, took me on walks and drives, never lost patience with me. Dr Wilhelm because she made time for me to see her every week, talked to me, listened to me for an hour at a time, introduced me to cognitive therapy, and prescribed anti-depressant medicine.

The first, Prozac, which at the time was a comparatively new drug, made me feel even worse and made me shiver uncontrollably. Then she prescribed an older drug, Tolvon, and over the next couple of weeks the medication began to take effect and seemed to make a slight, but noticeable, improvement in my condition.

Slowly, very slowly, I felt myself getting better. The anxiety receded. I finally went back to lecturing. I started feeling almost normal. I was told that, having depression once, I was more likely to get a recurrence. So far it hasn’t happened, but I would never be foolish enough to think it never will.

Why did it strike me down? I mean, here I was, enjoying life to the full, married with four children, a scholarship boy at Cranbrook School and Sydney University, A-grade journalist, writer, professor, allegedly a high achiever, climbing higher and higher. Yet, I remember feeling, very strongly, I’d let my family down by not achieving more; I hadn’t done them justice – not just my own family, but the generations of hill farmers down at Brogo on the south coast, where the McGregors had come from.

Dr Wilhelm said to me: ‘‘You’ve got a lot hidden about your family.’’

As I’ve written in my memoir, Left Hand Drive: ‘‘Death keeps tracking us down. Randolph McGregor took a rifle and shot himself in the bush. Douglas McGregor, my grandad, left a plough for the Bega Showground and little else. In the lonely scrub back from the farmhouse, we found an old steel bed where some of the McGregors had tried to build a separate life. It failed.

‘‘There has always been an element of tragedy in the life of the McGregors, in Scotland and in Australia, or at least our branch of them. Theirs was a tough and unforgiving life, marred by failure, hardship, depression – the last of which has afflicted me and my brothers. Yet, through it all, good humour and optimism. Maybe it wasn’t just royal blood we inherited, but a sense of fairness, and its obverse, a sense of injustice: a virus of the heart.’’

A virus of the heart. Perhaps, at its black core, that is what depression is all about.

Support is available for anyone who might be distressed by calling:

Lifeline 131114

Mensline: 1300789978

Kids Helpline: 1800551800

Former Fairfax journalist and two-time Walkley winner Craig McGregor’s memoir Left Hand Drive, is published by Affirm Press.

9 comments

I have had moment of self doubt and self pity and thought that perhaps I was clinically depressed. How helpful to read an account that makes me realise that the feelings I have had pale into insignificance to the condition you are describing. Continue to proclaim your message and encourage others to talk about it. Whether the cause lies in our genetic make-up or our socialisation, we should all fight for destigmatisation and mental health funding. No one in our society should be suffering like that.

Commenter

Aussie Expat

Location

Santiago, Chile

Date and time

June 10, 2014, 2:43AM

Craig, thank you.I would like to add to this. When it comes to trying to understand and conceptualise (unipolar) depressive disorders, some are seen to have a biological basis (melancholic or psychotic depression) and others are seen as having their basis in the interaction between an individual's personality/‘coping style’ and life events (so called non-melancholic depression). This is the hierarchical model/concept of classifying depression disorders. Depression is not seen as simply one condition that varies in severity; it is separated into different types of depression according to the symptoms. This influences decisions regarding selecting the most appropriate treatment.With the hierarchical model, there are different types of unipolar depression: • Psychotic depression - with psychotic symptoms, rare;• Melancholic depression - with psychomotor symptoms, uncommon;• Non melancholic depression or ‘depressive spectrum disorders’, common.Please note: when enquiring about depressive symptoms, it is important to also enquire about the symptoms of bipolar disorder (in order to exclude that diagnosis).To reiterate: Some depressive disorders appear to have a biological basis and may develop in individuals with no obvious personality vulnerability or predisposing factors (melancholic or psychotic depression) - and other depressive disorders appear significantly related to personality factors and the person's life circumstances (non-melancholic depression).The relative importance of these factors is not always obvious.Please note: At times, people may use the term 'depression' to describe experiencing an unpleasant emotion or difficult situation - but may not have a specific psychiatric disorder; here, a different approach may be required. Treatment options for a depressive illness include – ‘physical’ treatments (medication, ECT [electroconvulsive therapy], omega 3), psychological therapies (there are many), education, ‘stay well’ plan, lifestyle and adjunctive therapies (exercise, diet, no ‘drugs’, sensible alcohol consumption). The 300 word limit prevents elaboration.

Commenter

Howe Synnott

Location

Sydney

Date and time

June 10, 2014, 7:56AM

To continue:It is not unusual for someone to have a combination of both melancholic and non-melancholic depressive conditions; in this situation, the person would require treatment for both types of depression. The overwhelming majority of depressive disorders are the non-melacholic type.It is worth noting that for people with a non-melacholic depression, around 50% gain no significant benefit from antidepressant medication - and may require other interventions.

Commenter

Howe Synnott

Location

Sydney

Date and time

June 10, 2014, 8:46AM

Yes, it all sounds very sad. These matters must be talked about, and Craig does so well.It's a pity that at the end of the article we get a plug for another new book. It's something we are getting tired of at the Herald, I'm afraid.

Commenter

Bronte

Location

Bronte

Date and time

June 10, 2014, 6:01AM

I find it especially troubling that much of the medical profession, does not seem to acknowledge that an actual physical illness such as a simple bacterial infection of the body, can cause a change of events in the biochemical aspects of the body leading to depression, especially if the bacterial infection has been simmering away as a low grade infection in the body for any length of time, affecting the adrenal systems in the body.

I have known quite a few people, who developed depression, and after a lot of investigations, implemented by themselves, eventually found that some sort of low grade infection had caused their depression(eg sinusitis, tonsillitis, tooth infections, etc), and after they had treated their infection the depression that they had for months went away..

And other phsyical conditions such as diabetes etc if poorly controlled or undiagnosed also can cause depression in my experience.

Commenter

Siricus

Date and time

June 10, 2014, 9:55AM

Respectfully, I think you should consider the mounting scientific evidence that the combined effect of 140,000+ synthetic chemicals in the human environment may be having a major neurotoxic impact on humanity worldwide, and the links to observed increases in autism, ADHD, schizophrenia, depression and reduced intelligence - as described in Grandjean et al in The Lancet recently. The brain is the most sensitive and easily poisoned of all organs. Not so long ago doctors blamed stomach ulcers on the patient's mental state - 'stress' - a view now overturned by science in favour of a physical cause (H. pylori). But the tendency to see the patient (either genetically, mentally or in terms of behaviour) as the author of their own misfortunes persists, in spite of a growing pile of scientific evidence to the contrary. There may well be physical causes, or contributing factors, behind the global upsurge in mental disease and disability, but they are not yet receiving the scrutiny that the issue merits. And certainly little attempt is being made to exclude even the known neurotoxins from our food, drink, housing, workplaces and urban environment - such as vehicle and power station emissions or certain pesticides.

Commenter

Julian Cribb

Location

Canberra

Date and time

June 10, 2014, 10:08AM

I know the darkness you describe it follows me constantly, unfortunately I have little to look forward to, unemployed for over a year and unable to even get an interview. I find myself wondering what kind of future I can have. A goal or something to strive for is good but what happens when there is no goal, no way out?

Commenter

Hyperion

Date and time

June 10, 2014, 10:30AM

I feel for you Hyperion...and you are right, what does one do when circumstances beyond their control, forces one into a situation, which causes a person to develop depression?

Our govs, and especially this current one has a lot to answer to concerning peoples ill health, and their uncertain future.

Commenter

Redey

Date and time

June 10, 2014, 12:41PM

Mr McGregor - Please try to get hold of all the material by Kay Redfield Jamison - beginning with "An Unquiet Mind" - an enlightenment on one person's experience and theories with one type of depression.